(Part 1: Muscles matter too)
It is a myth to think that Osteopaths only treat joints. When we look at the human body we see it as a unit, where the joints, muscles and nerves are all interrelated.
You could argue that Osteopaths are more skilled at assessing and treating muscles than massage therapists.
Osteopaths in the UK spend 4-years learning the anatomy of our muscles. So you can be sure that we know the origins and insertions (where the muscle starts and stops) of the muscles. At Uni we also have to refine our ability to touch, and feel for the nuances of apparent tension. Many Osteopaths also take an additional massage course.
How Osteopaths Assess muscles
Osteopaths always assess joints, checking if they are aligned or “restricted”. But we also look at people globally and go on the hunt for any specific areas of aberrant tension. In other words, we try to identify localised areas of abnormal muscle tension. Often times a joint is restricted because of excessive muscular tension in the big muscles that cross a joint. Muscles can forcefully close the space between the bones, compressing the joint surfaces together, in what Shirley Sahrmann calls force closure.
When Osteopaths palpate and find tense muscles they assess to find out whether the tension of a muscle is functional. It is natural for our muscles to hold tension, which is called resting tonicity. Osteopaths are feeling for muscles that excessively restrict the passive lengthening of a muscle. We try to identify specific lines of tension, muscles which unnecessarily apparently contract.
After we have felt for unnecessary muscular tension, we take our hands-off and assess how much the muscles can lengthen. This is called an active range of motion assessment. We are looking for muscles that unnecessarily contract, and resist the lengthening process.
The next step is where the Osteopath assesses how the muscles passively lengthen, by doing the movement for our client. I personally just don’t focus on how much a muscle can stretch, but the entire range of motion, where I feel for an inappropriate kick in the muscle. When I assess for muscular tension I expect and want the muscle to tense up at the end of its range, for tension is our muscles way of trying to stabilise things. If our muscles didn’t tense up they would tear from overstretching. Although apparent tension in the mid-range of the tissues passive range often gets ignored, it does matter.
Unlike some massage therapists, Osteopaths won’t falsely tell you that: “you have a knot in the muscle”
Fibrosed knots in the muscle itself take years to develop, and only tend to happen after a major trauma.
Mechanical adhesions in essence are made up of disorganised scar tissue, making tissue that is stuck very rare. Whereas Aberrant tissue tension in our connective tissue, is common. Just because an area is tender to touch doesn’t mean it is a knot, as we all have tender spots!
As an Osteopath I see muscular tightness as being dynamic, because I know it changes. Tension in our muscles is controlled by our nervous system (software). Muscles are not sensations, they can’t function without information that it receives from our brains. In other words, more often than not it is the nervous system not the muscle that restricts mobility.
When Osteopaths do NOT manipulate tense muscles
When we realise that the muscle isn’t going wrong!
Our bodies have evolved to adapt to injuries and when we tear a muscle our nervous system helps to keep us safe, by splinting the area, and tensing up the muscles that surround the tear/strain. This reduces the risk of it re-tearing, giving the tissue time to heal up.
If a muscle is protecting a joint/nerve/other muscle, why would you want to stop it from doing its job?
When Osteopaths DO relax tense muscles
As an Osteopath I walk the tight-rope of not over relaxing muscles that are stabilising a strained joint or nerve. On the other hand we want to give tense muscles a break and enhance mobility lest chronic compensations set in.
It would be remiss of me to not reduce unnecessary tension, as an unresolved tension leads to inflammation. Tension reduces the flow of fluids into and out of the muscle, called motility. With insufficient motility of blood and lymph muscles become deprived of nutrients. What’s worse is waste products build up in the tissue, which leads to inflammation as the lymph cannot drain it away. This inflammation can irritate pain receptors at the ends of our nerves.
If not addressed chronic tension with associated inflammation increases the chances that fibrosis or calcification of muscles might occur.
How I treat tense muscles…
Being a hybrid of a therapist, I use a variety of relaxing techniques that don’t stop the stabilising function of the muscle. Here is a list of techniques I have stolen, I meant learnt over the years, these include…..
IAA: Isometric Agonist Antagonist (learnt from a chiropractor)
Rhythmic PNF: Post Neuromuscular facilitation (learnt from a Physio)
MET: Muscle Energy Technique (learnt on my degree)
Swedish Effleuge (learnt on my massage NVQ)
Lymph Drainage (learnt on my degree)